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COVID 19 and diabetes: a lethal partnership? How do we overcome this?

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By Dr. Kayathri Periasamy

With the latest wave of COVID-19 infections sweeping steadily across Sri Lanka, attention has been directed towards persons with uncontrolled, pre-existing conditions, particularly diabetes; as a sect most vulnerable to get severely ill or die because of complications caused by the virus. This has shed light on another growing concern among healthcare providers and patients, which is that patients suffering from diabetes or other chronic conditions are finding it increasingly difficult or are unable to access the medical care they require due to mandatory albeit essential curfew measures combined with a deep fear of contracting the virus in communal healthcare settings.

With a staggering 463 million adult diabetic patients present worldwide, World Diabetes Day 2020 – falling on the 14th of November- is a critical time for diabetes support communities and healthcare advocates to rally together to create awareness about this debilitating medical condition and push for progress in the standards of care and the better management of diabetic patients during a pandemic. In Sri Lanka alone, 1 in 10 adults are approximated to suffer from the disease. It is also then vital to look at ways to help stop more people from getting this disease, particularly at a time when ‘lockdown’ lifestyles are more often than not likely to be sedentary, unhealthy and stressful; an ideal background for a diabetes diagnosis.

Why is uncontrolled diabetes such a potent accelerant for COVID-19?

A recent study conducted by Lancet on Diabetes & Endocrinology screened over 61 million medical records in the U.K. to find that 30% of COVID-19 deaths can be attributed to people with diabetes. After accounting for factors such as demography and chronic medical conditions, the risk of succumbing to the virus was shown to be about three times higher for people with Type 1 diabetes and almost twice as high for Type 2, versus those without the disease. 

There appears to be two primary reasons driving this predicament. Over a lifetime, poor glucose control inflicts widespread damage in our systems which can lead to strokes, heart attacks, kidney failure, eye disease, and limb amputations. The linings of blood vessels throughout the body weaken to an extent where they can’t ferry necessary nutrients adequately. Inflammation is another byproduct of poor diabetes control, which makes the body ill-prepared for the onslaught of the viral disease. Secondly, the rich environment of elevated blood glucose present in diabetic patients, makes them prone to superadded bacterial complications during the viral infection. Many diabetics also tend to have other co-morbidities such as obesity, hypertension, and heart disease, which are all factors that aggravate complications during viral illneses. These problems are seen in any infections in the setting of diabetes and not only with COVID 19. The pandemic has just highlighted the difficulties of having diabetes

 

What precautions can diabetic patients take?

So during this pandemic, apart from strict adherence to general COVID-19 personal safety protocols such as strict social distancing and sanitization, it is important for patients to regularly monitor their glucose levels to avoid complications caused by fluctuating blood glucose. Proper hydration is essential for good health. It is also crucial to have access to a good supply of the prescribed diabetes medications and healthy food so that patients are able to correct the situation if blood glucose levels fluctuate. Finally, sticking to a comfortable daily routine, maintaining an exercise program even within the confines of your home, reducing excessive work and having a good night’s sleep can go a long way in keeping you strong. In essence, maintaining good blood sugar levels may be their best defense against severe COVID-19.

Disruption to continuity of care for diabetes patients

A rapid assessment survey conducted by WHO among Ministries of Health across many countries, focusing on the service delivery for NCDs during the COVID-19 pandemic, revealed deepening concerns that many people living with NCDs are no longer receiving appropriate treatment or access to medicines during the COVID-19 pandemic. The more severe the transmission phase of the COVID-19 pandemic, the more NCD care services were disrupted.

With our country currently in the cluster transmission phase and heading towards the community transmission phase due to the large and distant spread of the first-line contacts, the threat to NCD care and especially routine and emergency care of diabetes patients worries us physicians. As healthcare providers, we too are torn between the dilemma of not wanting to expose our patients to unnecessary hospital visits and the need to ensure that all our patients have continued access to their healthcare team along with a steady supply of medicines and other diabetes care products such as glucometer strips and insulin. Unfortunately, the delay in visiting their healthcare provider when they have symptoms of complications has caused many people to present late to the hospital with heart attacks or infections. A delayed presentation, weakens the patient further.

This disruption to healthcare services is foreseen to be a huge dilemma for patients and healthcare providers alike, especially when it comes to the care of patients with diabetes and other non-communicable diseases. In Sri Lanka, the Ministry of Health, is currently providing a number of telemedicine services and has opened avenues to deliver medicines to houses without diabetic persons having to visit crowded settings

 

How do we counter this?

At Healthy Life Clinic, we adhere strictly to COVID-19 safety operational health protocols established according to Ministry of Health (MOH), Epidemiology Unit. All incoming patients are screened by our nurses as soon as appointments are made over the phone, to understand the nature of their illness. If there is a worry that they could have contracted COVID-19 or have been in contact with such patients, they are given the opportunity to speak to the doctor first over the phone for a detailed history. Every patient will be consulted and no one is turned away from our care.

In order to help patients overcome barriers such as curfews or even the fear of entering communal healthcare settings, our experienced, highly-regarded team of consultants conducts telehealth consultations via established, trusted telemedicine partners such as oDoc and Mydoctor.lk to maintain continuity of care throughout this pandemic. We have also moved many of our long-standing diabetes care and weight management programs online, which have proven to be effective even in the absence of a physical meeting and examination. Additionally, our social media platforms and website are constantly updated to increase awareness about this condition, along with content that informs people about the proper management and prevention of diabetes – particularly when it is thus connected to COVID-19.

 

(Dr. Kayathri Periasamy is a consultant physician MBBS (UK), MRCP (UK), Board Certified in Int. Medicine (U.S.A). She is the founder of Healthy Life Clinic, Colombo 07.)

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INSEE Cement continues investment in mason development across Sri Lanka

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Sri Lanka’s leading cement manufacturer INSEE Cement is driving transformation across the local construction industry with significant investments in empowering one of the sector’s key stakeholder groups; the mason.

‘INSEE Sathkara’, a multifaceted initiative to develop local masons powered by INSEE Cement is shaping the mason of the future – a professionally, socially and financially empowered individual contributing significantly to the advancement of both the local construction industry and Sri Lanka’s economy.

“The INSEE Sathkara initiative facilitates empowerment and development through up-skilling, social recognition and financial stability, an all-round approach that has successfully nurtured a new generation of masons that are fast adaptable to industry demands through newly developed skillsets, knowledge and capacities,” says Jan Kunigk, Executive Vice President, INSEE Cement.

INSEE Cement’s approach is to build a certified and skilled workforce with recognized credentials to bridge a gaping skill gap in the construction industry. The program ensures sustainable capacity development for masons backed by National Vocational Qualifications (NVQ) in collaboration with the National Apprentice and Industrial Training Authority (NAITA) of Sri Lanka.

INSEE Cement also launched a Mason Apprenticeship Program to provide 120-day training opportunities for masons to learn on the job, preparing them to enter the workforce with specialized skillsets.

For Ajith Kumara Dissanayaka from Ambathenna, a mason for nearly 16 years, receiving all-round advancement through INSEE Sathkara has been truly life changing. “Five years ago, I was able to complete a course conducted by INSEE Cement and NAITA and received a Level 3 NVQ certification – my first professional credentials as a mason. This training gave me knowledge and insight that I had not received in over a decade of working as a mason, and it made me look at my profession differently. I improved my tile work skills, which also increased my income,” Dissanayaka stated.

This professional up-skilling has enabled INSEE Cement to create much needed social recognition and acceptance for Masons across Sri Lanka as a crucial link in the construction industry value chain. Mason Chats, Mason Meets and exclusive membership to the INSEE Concrete Society (ICS) has provided local masons industry inclusivity as well as recognition and rewards to encourage new avenues of income and entrepreneurship. Long-established ICS-member masons are also rewarded for their contribution to the local construction industry through ‘INSEE Garu Sara’.

To secure a stronger financial future for masons, INSEE Cement has introduced a comprehensive life insurance policy with disability, medical and accidental cover. This comes in addition to the pension scheme introduced to masons in partnership with the Employee Trust Fund Board (ETFB) of Sri Lanka.

“I joined the INSEE programme five years ago, and have benefited in ways I never imagined. The knowledge I gained about the industry, Sri Lanka Standards Institute (SLS) standards and safety requirements have made me a better professional, and my clients respect me more because of it,” stated Ratna Ravindara, a mason based in Kandy with over two decades of industry experience.

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European ride-hail Bolt enters Sri Lanka

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Bolt, the leading European transportation platform committed to making urban travel easier, quicker and more reliable; announced its entry to the Sri Lankan market, with a pilot launch of its service in Colombo, on November 25, 2020 with over 2000 drivers ready to start accepting rides. Bolt pilots its services in South Asia for the first time with the launch of operations in Sri Lanka.

Committed to affordable trips and happy drivers, the company has announced that it will be charging drivers no commission for using the platform and offer fares 20% lower than other competitors, for a minimum of six months. It builds on being smart about how to grow the company, and focusing operations on efficiency, allowing Bolt to pass the savings on to customers, passengers and drivers.

Bolt has chosen to enter Sri Lanka during the peak of the COVID-19 crisis with the firm belief that people still need to move around in the city and doing its best to fulfil the mission to help them do so. Currently available only within Colombo, Bolt services can be accessed by passengers by downloading the secure and free Bolt app from Apple App Store or Google Play Store and setting up a user profile. Any person with their own Car who wishes to join Bolt as a driver, can easily register with the company through https://partners.bolt.eu/driver-signup by completing the relevant formalities or through the Bolt Driver App available on Apple App store or Google Play Store.

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Mobisec marks 6th anniversary as its future outlook remains strong

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International footprint with branch office in Melbourne

Mobisec (Pvt) Ltd, an innovator in the mobile application sector in Sri Lanka is celebrating its 6thanniversary since its inception in November 2014.

Over the years it has served hundreds of thousands of customers across Sri Lanka through its telco and mobile applications. Starting with humble beginnings as a start-up, Ashen Gomez, Founder & Managing Director of Mobisec has worked diligently over the years alongside his wife Sumudu, the Co-founder of Mobisec to build the company and expand its services in different verticals.

The company marked its first international expansion in the beginning of this year by establishing a new branch office in Melbourne, Australia. Today, the company is home to a dynamic team of over 30 software development experts.

Founder & Managing Director of Mobisec Ashen Gomez said; “since inception, we have continued to create applications that revolutionize the way people connect with the technology. Our prime focus is to provide smart and reliable solutions for modern problems our customers are facing and help them improve the quality of their lifestyle.”

Company’s product portfolio expanded further during this year along with the three brand new products that were launched into the Market. “Baby’s Diary” is one of the Android Apps that was added to Mobisec’s product portfolio in the mid of this year and currently the App has crossed over 10,000 downloads. It’s an all-in-one parenting solution, which contains a variety of options to keep track on the baby’s activities while shopping for all the baby essentials. Since its launch, the App has gained widespread attention and it’s shaping to be a game changer for all new parents in Sri Lanka.

“We are pleased to say that the Baby’s Diary App is the first and only Parenting App developed in Sri Lanka exclusively for parents of new-borns.The challenges and struggles for a new parent have never been addressed through out the past and that’s where we strongly believed that the concept of Smart Parenting needs be introduced to the Sri Lankan market”, said PrasannaDahanayake, Product Manager/ Business Analyst of Mobisec.

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